AB0694 CORRELATION BETWEEN PATHOLOGICAL FINDINGS AND SALIVARY GLAND ULTRASOUND IN PATIENTS WITH CLINICAL SUSPICION OF SJÖGREN’S SYNDROME IN A TERTIARY HOSPITAL
Authors: M. Espinosa, M. Fernandez Castro, H. Godoy, J. L. Andréu Sánchez, A. Sánchez
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Sjögren's syndrome (SS) is a chronic systemic autoimmune disease that presents a great clinical heterogeneity, which condition a significant delay in its diagnosis. The current 2016 classification criteria for SS, according to ACR/EULAR, are based on five objective tests/data, including minor salivary gland biopsy (MSGB). These criteria do not include any imaging tests2. Ultrasound of the major salivary glands (MSGU) has been consolidated in Rheumatology as a rapid, non-invasive, accessible and cost-effective test that could be useful in the evaluation of patients with Sjogren's syndrome, both for diagnosis and follow-up of these patients. <h3>Objectives</h3> To evaluate the correlation between the histological results obtained from the minor salivary gland biopsy (MSGB) and the findings of the major salivary gland ultrasound (MSGU) in patients with suspected Sjögren's syndrome. <h3>Methods</h3> It is a cross-sectional study in a consecutive cohort of patients evaluated in the rheumatology clinics of a tertiary hospital for ten months with suspicion of SS who underwent a MSGB as part of the of the usual diagnostic process and who are proposed to perform an MSGU (parotid and submandibular, bilaterally). We used the ultrasound scoring system proposed by OMERACT in 2019 that is based on the homogeneity of the glandular parenchyma individually (0-3) and a total score (0-12) is made. Demographic, clinical, and histological data were collected from the patient's clinical history after performing the ultrasound. A descriptive and inferential analysis of data is carried out. <h3>Results</h3> Fifty-seven patients were included, with a mean age of 56.8 years, 87% being women. Of these, 31 patients were diagnosed with Sjogren's syndrome. The rest of the patients, 26 individuals, were considered the control group. Of the 22 patients with MSGB consistent with SS, 14 had pathologic MSGU. A total ultrasound score &gt;5 showed a sensitivity of 96% for the SS group with a negative predictive value (NPV) of 94%. The ultrasound total score was significantly higher in patients with positive SMGB and in patients diagnosed with SS compared to those with a negative BGSM and in patients not finally diagnosed with SS, respectively. The correlation between MSGB and MSGU presents a direct and significant (P&lt; 0.01) moderate (value=0.628) association. <h3>Conclusion</h3> The results of our study show a moderate positive correlation between ultrasonographic and histological findings, which supports the role of ultrasonography of major salivary glands in the diagnosis of Sjogren's syndrome. <h3>References</h3> [1]Jousse-Joulin et al. Video clip assessment of a salivary gland ultrasound scoring system in Sjögren's syndrome using consensual definitions: an OMERACT ultrasound working group reliability exercise. Ann Rheum Dis. 2019 Jul;78(7):967-973. [2]Astorri E, et al.Ultrasound of the salivary glands is a strong predictor of labial gland biopsy histopathology in patients with sicca symptoms. J Oral Pathol Med. 2016 Jul;45(6):450-4. [3]Mossel E, et al. Ultrasonography of major salivary glands compared with parotid and labial gland biopsy and classification criteria in patients with clinically suspected primary Sjögren's syndrome. Ann Rheum Dis. 2017 Nov;76(11):1883-1889. [4]Kim J-W et al. Salivary gland ultrasonography findings are associated with clinical, histological, and serologic features of Sjögren's syndrome. Scand J Rheumatol 2018;47:303–310. [5]Nieto-González JC. et al. Salivary gland ultrasound: Update. Med Clin (Barc). 2020. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.